Effects of a 12-week home-based exercise program on the level of physical activity, insulin, and cytokines in colorectal cancer survivors: a pilot study
The purposes of this study are to examine (1) the feasibility and efficacy of two different home-based exercise protocols on the level of physical activity (PA), and (2) the effect of increased PA via home-based exercise program on biomarkers of colorectal cancer.
Seventeen patients (age 55.18 ± 13.3 years) with stage II–III colorectal cancer completed the 12-week home-based exercise program. Subjects were randomized into either casually intervened home-based exercise group (CIHE) or intensely intervened home-based exercise group (IIHE). The primary outcome was the level of PA. Furthermore, insulin, homeostasis model assessment of insulin resistance, insulin-like growth factor axis, and adipocytokines were measured.
Both CIHE and IIHE program significantly increased the level of PA at 12 weeks compared to its level at baseline (CIHE, 10.00 ± 8.49 vs. 46.07 ± 45.59; IIHE, 12.08 ± 11.04 vs. 35.42 ± 27.42 MET hours per week). Since there was no difference in PA change between groups (p = 0.511), the data was combined in analyzing the effects of increased PA on biomarkers. Increase in PA significantly reduced insulin (6.66 ± 4.58 vs. 4.86 ± 3.48 μU/ml, p = 0.006), HOMA-IR (1.66 ± 1.23 vs. 1.25 ± 1.04, p = 0.017), and tumor necrosis alpha-α (TNF-α 4.85 ± 7.88 vs. 2.95 ± 5.38 pg/ml, p = 0.004), and significantly increased IGF-1 (135.39 ± 60.15 vs. 159.53 ng/ml, p = 0.007), IGF binding protein (IGFBP)-3 (2.67 ± 1.48 vs. 3.48 ± 1.00 ng/ml, p = 0.013), and adiponectin (6.73 ± 3.07 vs. 7.54 ± 3.96 μg/ml, p = 0.015).
CIHE program was as effective as IIHE program in increasing the level of PA, and the increase in PA resulted in significant change in HOMA-IR, IGF-1 axis, TNF-α, and adiponectin levels in stage II–III colorectal cancer survivors.
KeywordsColorectal cancer Exercise Insulin resistance IGFs Cytokine
National Research Foundation of Korea (NRF) (No. 2011-0004892 to J.Y.J.) and the National R & D program for Cancer Control, Ministry of Health and Welfare, Republic of Korea (1120230 to N.K.K).
Conflict of interest
No author has declared conflicts of interest. The authors have full control of all primary data and that we agree to allow the journal to review the data if required.
- 4.Chokkalingam AP, Pollak M, Fillmore CM, Gao YT, Stanczyk FZ, Deng J, Sesterhenn IA, Mostofi FK, Fears TR, Madigan MP, Ziegler RG, Fraumeni JF Jr, Hsing AW (2001) Insulin-like growth factors and prostate cancer: a population-based case–control study in China. Cancer Epidemiol Biomarkers Prev 10:421–427PubMedGoogle Scholar
- 6.Demark-Wahnefried W, Morey MC, Sloane R, Snyder DC, Miller PE, Hartman TJ, Cohen HJ (2012) Reach out to enhance wellness home-based diet-exercise intervention promotes reproducible and sustainable long-term improvements in health behaviors, body weight, and physical functioning in older, overweight/obese cancer survivors. J Clin Oncol 30:2354–2361CrossRefGoogle Scholar
- 7.Fairey AS, Courneya KS, Field CJ, Bell GJ, Jones LW, Mackey JR (2003) Effects of exercise training on fasting insulin, insulin resistance, insulin-like growth factors, and insulin-like growth factor binding proteins in postmenopausal breast cancer survivors: a randomized controlled trial. Cancer Epidemiol Biomarkers Prev 12:721–727PubMedGoogle Scholar
- 8.Friedenreich CM, Neilson HK, Woolcott CG, McTiernan A, Wang Q, Ballard-Barbash R, Jones CA, Stanczyk FZ, Brant RF, Yasui Y, Irwin ML, Campbell KL, McNeely ML, Karvinen KH, Courneya KS (2011) Changes in insulin resistance indicators, IGFs, and adipokines in a year-long trial of aerobic exercise in postmenopausal women. Endocr Relat Cancer 18:357–369CrossRefGoogle Scholar
- 14.Irwin ML, Varma K, Alvarez-Reeves M, Cadmus L, Wiley A, Chung GG, Dipietro L, Mayne ST, Yu H (2009) Randomized controlled trial of aerobic exercise on insulin and insulin-like growth factors in breast cancer survivors: the Yale Exercise and Survivorship study. Cancer Epidemiol Biomarkers Prev 18:306–313CrossRefGoogle Scholar
- 16.Juul A, Dalgaard P, Blum WF, Bang P, Hall K, Michaelsen KF, Muller J, Skakkebaek NE (1995) Serum levels of insulin-like growth factor (IGF)-binding protein-3 (IGFBP-3) in healthy infants, children, and adolescents: the relation to IGF-I, IGF-II, IGFBP-1, IGFBP-2, age, sex, body mass index, and pubertal maturation. J Clin Endocrinol Metab 80:2534–2542PubMedGoogle Scholar
- 20.Ligibel JA, Giobbie-Hurder A, Olenczuk D, Campbell N, Salinardi T, Winer EP, Mantzoros CS (2009) Impact of a mixed strength and endurance exercise intervention on levels of adiponectin, high molecular weight adiponectin and leptin in breast cancer survivors. Cancer Causes Control 20:1523–1528CrossRefGoogle Scholar
- 21.Ligibel JA, Giobbie-Hurder A, Olenczuk D, Campbell N, Salinardi T, Winer EP, Mantzoros CS (2009) Impact of a mixed strength and endurance exercise intervention on levels of adiponectin, high molecular weight adiponectin and leptin in breast cancer survivors. Cancer Causes Control 20:1523–1528CrossRefGoogle Scholar
- 22.Ligibel JA, Meyerhardt J, Pierce JP, Najita J, Shockro L, Campbell N, Newman VA, Barbier L, Hacker E, Wood M, Marshall J, Paskett E, Shapiro C (2012) Impact of a telephone-based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting. Breast Cancer Res Treat 132:205–213CrossRefGoogle Scholar
- 23.Ligibel JA, Meyerhardt J, Pierce JP, Najita J, Shockro L, Campbell N, Newman VA, Barbier L, Hacker E, Wood M, Marshall J, Paskett E, Shapiro C (2012) Impact of a telephone-based physical activity intervention upon exercise behaviors and fitness in cancer survivors enrolled in a cooperative group setting. Breast Cancer Res Treat 132:205–213CrossRefGoogle Scholar
- 24.Ligibel JA, Partridge A, Giobbie-Hurder A, Campbell N, Shockro L, Salinardi T, Winer EP (2010) Physical and psychological outcomes among women in a telephone-based exercise intervention during adjuvant therapy for early stage breast cancer. J Womens Health (Larchmt) 19:1553–1559CrossRefGoogle Scholar
- 25.McTiernan A, Sorensen B, Yasui Y, Tworoger SS, Ulrich CM, Irwin ML, Rudolph RE, Stanczyk FZ, Schwartz RS, Potter JD (2005) No effect of exercise on insulin-like growth factor 1 and insulin-like growth factor binding protein 3 in postmenopausal women: a 12-month randomized clinical trial. Cancer Epidemiol Biomarkers Prev 14:1020–1021CrossRefGoogle Scholar
- 28.Meyerhardt JA, Heseltine D, Niedzwiecki D, Hollis D, Saltz LB, Mayer RJ, Thomas J, Nelson H, Whittom R, Hantel A, Schilsky RL, Fuchs CS (2006) Impact of physical activity on cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Clin Oncol 24:3535–3541CrossRefGoogle Scholar
- 29.Morey MC, Snyder DC, Sloane R, Cohen HJ, Peterson B, Hartman TJ, Miller P, Mitchell DC, Demark-Wahnefried W (2009) Effects of home-based diet and exercise on functional outcomes among older, overweight long-term cancer survivors: RENEW: a randomized controlled trial. JAMA 301:1883–1891CrossRefGoogle Scholar
- 35.Rinaldi S, Cleveland R, Norat T, Biessy C, Rohrmann S, Linseisen J, Boeing H, Pischon T, Panico S, Agnoli C, Palli D, Tumino R, Vineis P, Peeters PH, van Gils CH, Bueno-de-Mesquita BH, Vrieling A, Allen NE, Roddam A, Bingham S, Khaw KT, Manjer J, Borgquist S, Dumeaux V, Torhild Gram I, Lund E, Trichopoulou A, Makrygiannis G, Benetou V, Molina E, Donate Suarez I, Barricarte Gurrea A, Gonzalez CA, Tormo MJ, Altzibar JM, Olsen A, Tjonneland A, Gronbaek H, Overvad K, Clavel-Chapelon F, Boutron-Ruault MC, Morois S, Slimani N, Boffetta P, Jenab M, Riboli E, Kaaks R (2010) Serum levels of IGF-I, IGFBP-3 and colorectal cancer risk: results from the EPIC cohort, plus a meta-analysis of prospective studies. Int J Cancer 126:1702–1715PubMedGoogle Scholar
- 38.Suzuki S, Kojima M, Tokudome S, Suzuki K, Ozasa K, Ito Y, Inaba Y, Tajima K, Nakachi K, Watanabe Y, Tamakoshi A (2009) Insulin-like growth factor (IGF)-I, IGF-II, IGF binding protein-3, and risk of colorectal cancer: a nested case–control study in the Japan Collaborative Cohort study. Asian Pac J Cancer Prev 10(Suppl):45–49PubMedGoogle Scholar